Get Ca Access Tlc Hcba Waiver Application 2019-2025

The CA Access TLC HCBA Waiver Application is essential for individuals seeking access to home and community-based alternatives. This guide will provide you with comprehensive, step-by-step instructions to help you complete the application online with ease.

Follow the steps to accurately complete the application.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin with the applicant’s name and home phone number. Fill in the marital status by selecting either 'Yes' or 'No'. Enter the date of birth and age in the designated fields.
3. Indicate the applicant's sex by selecting the appropriate option. Provide the county of residence.
4. Specify the current living situation of the applicant by selecting one of the available options: at home, hospital, nursing facility, or other. Complete additional fields as required based on the option selected.
5. Enter the applicant’s current mailing address along with any alternative street address if applicable.
6. Complete the health care insurance section by answering whether the applicant has Medi-Cal, Medicare, or other insurance. If yes, provide the necessary details such as Medi-Cal number or other insurance names.
7. List the current medical diagnoses clearly. Identify the medical needs by checking the appropriate boxes and providing additional information where required.
8. Proceed to indicate legal authority for health care decisions, answering whether the applicant or their legal representative has been notified about the application submission.
9. Identify all current service providers and fill in the required details including type of services received and hours of service.
10. Once all sections of the form are completed and reviewed, save changes and prepare for submission. You can download, print, or share the completed form to ensure it meets your submission needs.

Complete your CA Access TLC HCBA Waiver Application online today for prompt processing.